FOAMdation

Decompensated liver disease and cirrhosis are common pathological states present on the gastroenterology ward. It is important to understand the basic principles of management and aetiology as a junior doctor in these complex and unwell patients. 

Dr Liz Sweeney is a specialist hepatology registrar at the Royal Liverpool Hospital. In this episode, she talks to us about decompensated liver disease and cirrhosis with key advice to junior doctors working in hospitals

Speak soon,

Ollie Wright

GET IN TOUCH! Either through the comments section or email [email protected] if there are any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily!

SHARE US with others you think would benefit or even your training leads to help us distribute the resource further! Twitter: @FOAMdation

Acute alcohol withdrawal and alcoholic hepatitis are common scenarios presenting to the Emergency Department (ED) and the ward. Recognition, investigation and management principles are imperative to prevent serious complications. 

Alcoholic hepatitis accounts for 3.3 million deaths worldwide and reports show an average mortality of 6.7% with acute alcoholic hepatitis, rising significantly with increased severity. It is characterised by acute inflammation of the liver due to excessive recent alcohol intake concomitant with COAGULOPATHY and JAUNDICE.

Dr Liz Sweeney is a specialist hepatology registrar at the Royal Liverpool Hospital. In this episode, she talks to us about acute alcohol withdrawal and alcoholic hepatitis with key advice to junior doctors working in hospitals.

 

Speak soon,

Ollie Wright

 

GET IN TOUCH! Either through the comments section or email [email protected] if there are any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily!

SHARE US with others you think would benefit or even your training leads to help us distribute the resource further! Twitter: @FOAMdation

Atrial Fibrillation is the most common arrhythmia and it can often feel like an on call shift is dominated by patients with AF when it is not controlled. Patients with AF present to Emergency Departments and acute medical takes frequently and it complicates many surgical patient admissions too. On the face of it, it is simple to manage with well-defined treatment options. However, the actual decision-making can feel unfamiliar and less straightforward when the picture becomes more complicated.

Professor Kahled Albouaini is a Consultant Cardiologist at the Royal Liverpool and Broadgreen University Hospitals, Liverpool. In this episode, he takes us through AF and simplifies many of the concepts and treatment options. As a bonus, we have a second VIDEO episode entitled "The Many Faces Of AF" that takes you through some of the ECG findings in AF and how to approach them.

Consider in each patient the four pillars of AF:

Trigger - assess for, investigate and treat any underlying causes

Rate (or rhythm) control - initiate beta-blockers and increase as needed

Anti-coagulation - assess stroke risk and bleeding risk

Echocardiogram - assesses the burden of AF, LV function and the presence of a thrombus

Thank you to Professor Albouaini for his help in producing this resource. You can check out his cardiology resources on facebook by searching for Cardiology Cases UK or take a look at his site that offers basic and advanced courses in cardiology: www.cardiologycases.co.uk

 

Speak soon

Gareth

@garEMlyn

GET IN TOUCH! Either through the comments section or email [email protected] if there are any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily!

SHARE US with others you think would benefit or even your training leads to help us distribute the resource further! Twitter: @FOAMdation

Difficult conversations are exactly that: difficult. They may be difficult for numerous factors that are related to the subject matter, the patient, their relatives and friends and yourself. The first time you go through one of these conversation, you may feel drained, raw and emotional or you may not feel affected at all.

Dr James White is not just a GP but also an anaesthetic registrar in training who regularly works across critical care and has held numerous roles in medicine. The podcast goes through some different situations that may form a continuum of discussion from the delivery of a test result and possible life-changing diagnosis, the discussions that may take place when faced with an acutely unwell patient and end of life and DNACPR decisions. The episode discusses theprocess in more detail with input from a discussion on Facebook.

 

GET IN TOUCH! Either through the comments section or email [email protected] if there are any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily!

SHARE US with others you think would benefit or even your training leads to help us distribute the resource further! Twitter: @FOAMdation

Acute Kidney Injury (AKI) is a disease process that carries a significant mortality impact. The complications that accompany AKI can be difficult to manage and may require specialist input if resistant to treatment. The management of AKI also changes when faced with some special situations.

Dr Aled Lewis is a Consultant Nephrologist at Glan Clwyd Hospital, North Wales. In this second part focussed on AKI, we discuss the complications of AKI, their management and some special situations that may alter the management of AKI.

 

Speak soon

Gareth

@garEMlyn

GET IN TOUCH! Either through the comments section or email [email protected] if there are any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily!

SHARE US with others you think would benefit or even your training leads to help us distribute the resource further! Twitter: @FOAMdation

Acute Kidney Injury (AKI) I is a medical emergency that has received significant media attention in recent years. It has a significant impact on long term outcomes for patients.

 

Gareth speaks with Dr Aled Lewis, a Consultant Nephrologist at Glan Clwyd Hospital, North Wales about AKI and the general approach towards diagnosis and management.

 

Read the accompanying blog post at www.foamdation.com

 

Part 2 will follow shortly which cover specific complications and special situations.

 

GET IN TOUCH! Either through the comments section or email [email protected] if there are any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily!

SHARE US with others you think would benefit or even your training leads to help us distribute the resource further! Twitter: @FOAMdation

Head injuries are not just common to the Emergency Department, but common occurrences when covering the wards as a junior doctor. They can present a challenge both in assessment and investigating appropriately.

 

Gareth talks to Dr Mike Aisbitt, a Consultant in Emergency Medicine and Paediatric Emergency Medicine at Southport and Ormskirk NHS Trust about how to assess a patient with a head injury, who needs a CT scan and consideration of the medication they take including Warfarin, DOACs and Clopidogrel (?!)

 

Visit www.foamdation.com for the accompanying blog post discussing the topic.

GET IN TOUCH! Either by the website òr email [email protected] with any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily.

SHARE US with others you think would benefit or anyone who can help distribute the resource further.

Speak soon

How do I manage a patient with diabetes who is going for surgery? Should I start  vsriable rate insulin infusion? When does there normal treatment get restarted? 

 

Scott speaks to Dr David Ewins, Consultant Physician in Endocrinology and Diabetes about the subject, going into depth about how exactly to manage the different regimes of glycaemic control patients may present to you. They discuss some of the common pitfalls in the management of the surgical patient with diabetes and how to tackle these.

 

Visit www.foamdation.com for the accompanying blog post discussing the topic.

GET IN TOUCH! Either by the website, or email [email protected] with any comments or corrections or if you want to be involved with future topics. RATE US on iTunes to help others find the resource more easily. SHARE US with other you think would benefit or anyone who can distribute the resource further.

 

Speak soon.

Over 280000 falls occur in acute, community and mental health hospitals across England and Wales each year. These falls can increase length of stay, prevent return to previously independent living and at worst result in injuries and death.

Gareth talks with Dr Josh Deb-Barman, a speciality doctor in Elderly Care Medicine and Stroke Medicine at the Ciuntess of Chester Hospital. The episode is longer than normal and may take a couple of sittings to listen to. The subject is deep and complex and well worth thinking about carefully.

Visit www.foamdation.com for the accompanying blog post discussing the topic.

GET IN TOUCH! Either by the website òr email [email protected] with any comments or corrections or if you want to be involved with future topics.

RATE US on iTunes to help others find the resource more easily.

SHARE US with others you think would benefit or anyone who can help distribute the resource further.

Speak soon

Bowel obstruction is a common surgical presentation and in the presence of ischaemia carries a mortality up to 40%.

What makes the diagnosis? How good are the investigations?

Gareth talks to Miss Nicola Eardley, Consultant General and Colorectal Surgeon at Chester, about the important steps in the diagnosis and management from history and examination to imaging and further management.

Check out the accompanying post for discussion points and references used in producing this episode.

Rate us on iTunes if you liked what you heard and follow us on Twitter @FOAMdation. Please get in touch via www.foamdation.com or email [email protected] if you have any comments or suggestions. If you like what you hear then share us so others can get the benefit too!